If you want a toy, eat your broccoli

Later this year, as a result of the Healthy Food Incentives Ordinance, San Francisco restaurants will no longer be permitted to provide toys with kids’ meals that do not meet certain nutritional standards. The meals must have fewer than 600 calories, less than 640 milligrams of sodium, and contain a minimum of a half-cup of fruit and three-quarters of a cup of vegetables in non-breakfast meals. Drinks must obtain less than 10 percent of their calories from added sugars.

The law is aimed at addressing “epidemic proportions” of obesity and the detrimental health outcomes for people, especially children, who are obese. The law’s language draws on results from several surveys, including one that demonstrated the high frequency of eating at restaurants, especially fast food restaurants. A poll cited in the law asked parents about their greatest concerns for their children, and among the parents’ top concerns was their children’s weight. By prohibiting toys from being given away with unhealthy foods, the ordinance is intended to encourage parents and children to make healthier choices when eating in restaurants. Although the law has gained the media’s attention because San Francisco is the first large city to enact such an ordinance, other cities nationwide are also placing nutritional restrictions on children’s meals and requiring restaurants to provide nutritional information to their patrons. Similarly, the World Health Organization recently recommended a ban on junk food in settings where children gather (e.g., schools and playgrounds).

Reinforcing ‘good’ behavior

The San Francisco law and others like it have met resistance from some groups on the grounds that the laws are regulating private behaviors and undermining parental responsibility. But others are voicing concerns that young children are unable to distinguish between advertising and educational information. In fact, good nutrition advocate Marion Nestle, PhD, MPH, of New York University, advises that some of the marketing, such as including toys with meals, strongly influences children’s food preferences, requests and consumption. These marketing campaigns explicitly attempt to undermine family decisions by convincing children they should control what they eat and should eat foods “just for them.”

Essentially, those in favor of laws like that in San Francisco argue that children are learning an association between high-calorie, low-nutrient foods and a reward (i.e., the toy), and that positive reinforcement for eating poorly may increase poor eating habits. Could San Francisco’s ordinance increase healthy eating for children by providing toys in healthy meals and making nutritious food rewarding? A leading researcher on childhood obesity from the University at Buffalo, Leonard Epstein, PhD, and his colleagues recommend that the goal should be to shift children’s preference from eating less healthy but highly reinforcing foods to eating healthier but less reinforcing foods. To achieve this shift, Epstein says that nonfood alternatives — such as toys — could serve as reinforcement for healthier foods. Thus, as the San Francisco law provides, if restaurants provided toys along with healthier meals, the toys may increase preference for, requests for and consumption of healthy food.

A research opportunity

This is an important time for psychological research to address whether the toys are serving as reinforcers or the food in the kid’s meal itself is reinforcing. If research can demonstrate that the toys increase preference for, request for and consumption of unhealthy meals, then anti-obesity ordinances regulating toys in unhealthy meals may be directed at the correct issue. However, if the unhealthy food itself is the attraction, then removing toys from unhealthy restaurant meals may not be an effective approach for reducing childhood obesity.

“Judicial Notebook” is a project of APA’s Div. 9 (Society for the Psychological Study of Social Issues).